吡喃阿霉素方案治疗初治年轻患者急性髓性白血病(英文)  

Regimen containing perarubicin for the treatment of newly diagnosed young patients with acute myeloid leukemia

作　　者：钟立业[1] 李群华[1] 黄梓伦[1] 林伟[1] 陆泽生[1] 翁建宇[1] 吴穗晶[1] 杜欣[1] 

机构地区：[1]广东省人民医院血液科,广东广州510080

出　　处：《癌症》2009年第6期619-625,共7页Chinese Journal of Cancer

摘　　要：背景与目的:含有蒽环类抗生素的方案已经成为了治疗急性髓性白血病的标准治疗。本研究以米托蒽醌方案为对照,探讨了含有吡喃阿霉素(perarubicin,THP)的联合化疗方案在年轻急性髓性白血病的患者治疗中的疗效与毒性。方法:129例初治急性髓性白血病入组,年龄≥16岁而<60岁,诱导化疗给予常规剂量的阿糖胞苷及THP或米托蒽醌(MIT)。完全缓解(CR)后,患者接受两个疗程的原诱导方案的化疗;此后,交替应用含有THP及MIT的方案进行巩固治疗,三周一个疗程,共四个疗程。在持续缓解的情况下,维持治疗共三年。结果:在42例接受THP诱导缓解治疗的患者中,26例(61.90%)患者达到CR;73例以MIT作为诱导缓解治疗的患者中,有48例(65.75%)达到CR。两者比较,无显著的统计学意义(P>0.05)。在THP进行诱导治疗的患者中,9例(34.61%)患者在一年内出现复发;而MIT治疗的患者其一年内的复发率为22.92%;但经统计分析后发现,两者之间无统计学意义(P=0.28)。对诱导化疗中两种方案阿糖胞苷(Ara-C)加THP或Ara-C加MIT的副作用进行比较发现,除脱发发生率THP组(26.19%)低于MIT组(42.47%)外(P<0.01),其它毒副反应如感染、恶心、呕吐及心脏事件,发生率几乎相同(P>0.05)。结论:THP加Ara-C的方案能够用于年轻成人的初治白血病的诱导化疗,但其并不优于含有MIT的方案;在完全缓解后,THP和MIT可用于巩固治疗中。Background and Objective= Chemotherapy regimen containing anthracyclines has been used as the standard treatment for acute myeloid leukemia （AML）. This study was to compare the efficacy and toxicity of the chemotherapy regimen containing perarubicin （THP） with that containing mitoxantrone （MIT） for young patients with newly diagnosed AML. Methods. A total of 129 patients with newly diagnosed AML, aged 16 to 60 years olds,were assigned for induction chemotherapy containing one to two courses with standard-dose cytarabine （Ara-C） and an anthracycline antibiotic, THP or MIT. When complete remission was achieved after induction therapy, the patients received two courses of consolidation therapy identical to the induction regimen. From then, the patients were alternately given four courses of consolidation therapy consisting of Ara-C/THP or Ara-C/MIT every three weeks. Maintenance treatment continued for three years when patients were in continuous complete remission （CCR）. Results. Twenty-six out of 42 patients （61.90%） receiving THP therapy, and 48 out of 73 patients （65,75%） treated by MIT achieved CR （P〉0.05）. Nine （34.61%） and 11 （22.92%） out of CR patients treated by THP and MIT, respectively, relapsed within one year （P= 0.28）. Moreover, the incidences of toxicities, such as infection, nausea/vomiting and cardiac events, were similar in these two groups （P〉0.05） except for alopecie, which was 26.19% in the THP group compared to 42.47% in the MIT group （P〈0.01）. Conclusions： Regimen containing THP plus Ara-C can be used for young adults with newly diagnosed AML for remission induction, but it is not superior to the regimen with MIT.Consolidation chemotherapy with THP or MIT is feasible for young adults with AML after CR.

关 键 词：急性髓性白血病 吡喃阿霉素 米托蒽醌 诱导化疗 缓解后治疗 

分 类 号：R733.71[医药卫生—肿瘤]